A 63-year-old man presented with facial numbness and crusted lesion on the left side of his face. He first noticed that something was wrong when he had significant ear pain in his left ear two days earlier. He noted that he regularly takes methotrexate for his rheumatoid arthritis.
A 38-year-old African American woman visited her doctor complaining of a cough, wheezing, and swollen glands. She also noticed that over the past month she had started to develop smooth plaques on her upper back.
24 hours after playing outside in the cold fall weather with her children, a 43-year-old woman with a history of systemic lupus went to the doctor complaining of palpable purpura on her hands and feet. They were painful and pruritic.
In 2016, Dermatology Times, in partnership with VisualDx, quizzed you on a number of different skin disease diagnoses. From morphea to poikiloderma of civatte to livedo reticularis, we’ve shown cases that have stumped the most experienced dermatologists.
Here are the three most-puzzling quizzes of 2016.
A 50-year-old Indiana farmer visited his doctor with flu-like symptoms including a fever, chills, productive cough, myalgia, and pleuritic chest pain that developed over a few weeks. What worried him was a crusted lesion on his arm that was a large verrucous scaly plaque.
A 30-year-old woman asked her primary care doctor about bluish-brown hyperpigmented patches that had developed on her neck over the past several weeks. She had recently gotten over a parasitic infection after visiting extended family outside the United States.
At her regular OB appointment, a 31-year-old woman pregnant with her first child expressed concern about a nodule that had appeared on her lip in the past two weeks. Currently in her third trimester, she had only been taking prenatal vitamins since the beginning of her pregnancy. The red, friable papule had a well-defined rim of skin at the base and would bleed spontaneously if accidentally brushed against.
A 7-year-old boy went with his mother to the dermatologist for evaluation of multiple skin lesions on his cheeks, nose and upper lip. They had developed over the last six months and hadn’t been bothering him, except that he didn’t like the way they looked. His mother had encouraged the visit because she had similar firm, smooth papules in the same facial area when she was an adolescent and had them treated.
A mother brought her 3-year-old son into the pediatrician with a complaint of multiple skin lesions on his thumb, which he frequently sucked for comfort. The grouped configuration of lesions were painful and had developed over the last 5 days to become vesicles. The doctor noted upon exam that he had a nearly healed cold sore on his lip, pain in his wrist, and an elevated temperature.
A 40-year-old farmer in southern Florida visited the emergency room concerned about a plaque with ulcer on his arm that developed along the lymphatics shortly after a small wound he received on the farm. He was very worried when it looked like another lesion was beginning to form.